Local Home Care Agencies Need More Caregivers To Meet Growing Demand From Aging Population

Barbara Raynor, who is in her early 70s, sometimes finds herself working 12-hour shifts as an in-home caregiver, because her agency, Home Instead Senior Care in Hampton Bays, often needs an extra hand.

She isn’t the only home care professional on the South Fork working overtime to address the shortage of workers. Several local agencies are feeling the strain of not having enough staff to keep up with the region’s growing elderly population that needs help at home.

Home Instead Senior Care administrators regularly ask their nearly 70 caregivers, who are mostly between 55 and 65 years old, to work longer hours to cover clients living between Holtsville and Orient Point and Montauk. Shene Nursing Service in East Hampton is losing money because of how many overtime hours its 30 caregivers are accumulating.

“Last year was probably the first year when I really started to feel it, and this year I just … I can’t believe it,” Bethany Shene, owner of Shene Nursing Service, said of the lack of available caregivers. “The amount of overtime that we’re paying is unbelievable.”

Tracy Zaweski, the franchise owner for Home Instead, called the local shortage a “crisis.”

“In the beginning, it wasn’t as difficult to find good people,” said Ms. Zaweski, who opened the franchise in 2009. “But now, the demand is so much higher than the supply.”

While working to capacity, Home Instead and Shene Nursing administrators said they still find themselves turning down potential clients seeking their services every day, many of whom are being discharged from hospitals.

“A lot of times, we feel bad when a client calls, and sometimes somebody is being discharged from a facility and they desperately need the help,” Ms. Zaweski said. “We wish we can help them—and that’s the part that hurts. If we had the staff, we would be servicing more clients.”

Home care may be provided by medical caregivers, known as home health aides or personal care aides, or by non-medical caregivers, generally referred to as companions, depending on the needs of the individual.

Mary Jean McKeveny has worked closely with the Stony Brook Southampton Hospital and Stony Brook Eastern Long Island Hospital in Greenport as a community health nurse to transition elderly patients back to their homes. She knows the East End’s supply and demand for caregivers very well, as she has spent 25 years pairing patients with home health aides and leading programs that support family members who take on the role of caregiver.

Ms. KcKeveny said that she has noticed both a decrease in the number of caregivers and an increase in senior citizens who need caregiving services—creating stress from both sides of the equation. She works as a director of patient services at Gurwin Certified Home Health Agency, based in Commack, and was a director prior to that at the Dominican Sisters Family Health Services, which has since closed.

The nation’s increasing elderly population—and shrinking younger population—has been on the radar for at least a decade. By 2035, people who are 65 years and older are projected to outnumber children for the first time in U.S. history, according to U.S. Census Bureau data. Five years prior, 2030 will mark the year when all baby boomers will be older than 65 years old, meaning that one in every five residents will be of retirement age, according to the Census Bureau.

Locally, a long-range planning study of the Southampton School District that a third party conducted this past school year showed shifts in the age structure of the district population that reflected nationwide trends. Between 2000 and 2016, residents 65 years and older increased from 18 to 26 percent, while residents 19 years and younger decreased from 22.9 to 16.3 percent.

The shortage stems not only from the nationwide population changes but also from transportation issues and an absence of local affordable housing. It all makes fewer caregivers available to serve the area, Ms. McKeveny and agency owners have noticed.

Ms. Shene said she lost half of her staff since opening her agency in 2004 because summer traffic and the cost of living has made it nearly impossible for them to work in East Hampton Town. She said she had even let some aides temporarily stay in her home to avoid long commutes.

“Unless you live in your community and provide care out there, it can be a nightmare for aides to travel into the area,” Ms. McKeveny said.

Beth McNeill had done research on the expanding senior community, so when she opened her business in 2013, Artful Home Care in Southampton Village, she prioritized the need to hire and retain enough staff.

Unlike other local agencies, Artful Home Care takes on a holistic approach to caregiving, with art, music and wellness components, and she credits that as the reason she has managed to retain her team of over 25 employees. That, and the pay, she said.

“I think that there’s probably somewhat of a shortage on the East End, because not many of them are paid well enough to be able to reside and live in the community and work in the community,” Ms. McNeill said. “That’s where we have found that paying our caregivers a couple of dollars more does help with retaining.”

Some agencies are starting to think about how they can mitigate the problem. Offering training courses for local residents seeking year-round employment is a route that a few of them are turning to. However, Home Instead already offers training for its caregivers and still has difficulty finding people to fill vacant positions.

Ms. Shene is working on renewing her certification to hold her own training courses for home health aides and personal care aides. She was certified years ago to train others, but she did not hold any classes for a two-year period, and the certification lapsed, to her surprise.

“I had the certification to have the training class and I just didn’t need it because I didn’t have a problem hiring staff,” Ms. Shene said. “Now, I wish I had it cause I could really use it.”

When she becomes certified, which she said she hopes to be in the next month or so, she plans to hold training programs out of her East Hampton office, which is large enough to train 15 people at a time. The course would take two and a half weeks, so dedicating that stretch of time may pose a challenge for people who already have a job, she said.

Late last month, Ms. McKeveny helped lead a three-week training course in Greenport to certify people to become home health aides. Gurwin Home Care Agency, a Farmingdale-based agency that offers companion care, hosted the course for its first time ever and brought in certified instructors from its affiliate, Gurwin Certified Home Health Agency, where Ms. McKeveny works.

The agency partnered with Community Action Southold Town to host the class as a way to address the growing need for caregivers as well as offer employment opportunities. Three people had graduated from the course and the agency’s director, Nancy Geiger, said that two of them were matched with clients shortly after the course ended.

Ms. Geiger said that another training session is now being planned on the South Fork for the fall.

“We clearly do see a need on the East End—on the forks, particularly. And it’s based on the fact that we know that there are more baby boomer-aged people retiring and moving out there, so the need is going to only increase over the coming years,” she said.

The isolation of the North and South Forks was something that Ms. Geiger and her colleague at Gurwin, Dennine Cook, pointed out as one of the biggest challenges to finding more caregivers.

“Because of the rural-ness of the forks, and the isolation sometimes out there, especially not in the summer, it’s hard to find that care,” said Ms. Cook, the chief public relations officer of Gurwin Family of Healthcare Services. “The closer you get to the city, or into Suffolk County, there’s more aides available and the home care is more of a viable option.”

Maureen Fagan, who works alongside Ms. Cook, chimed in to the conversation to share how she and her husband regularly travel from Commack to care for her in-laws living in Orient Point, about 65 miles away.

“They have their frequent stops at the hospital for different things that the adult children really can’t be all the way out there, so you need an extra set of hands and it’s so difficult to find anybody,” Ms. Fagan said of her in-laws, who are in their 80s. “They’re at the tip, you know. It’s difficult to find health care out there.”

There are private caregivers in the area that also offer services informally, advertising in the same way a babysitter might. They can become competition to local agencies because of their often cheaper rates, but the need for more workers is still present as agencies reject daily requests. Offering private care concerns Ms. Geiger because of its lack of supervision and regulation by the New York State Department of Health, she said.

Agency officials are also finding that more senior citizens are choosing to “age in place,” meaning in their own home rather than in a facility, because it generally is a cheaper and more comfortable option.

Ms. Zaweski of Home Instead said she believes that the growing number of home care agencies that have opened nationwide in recent years has popularized the idea of staying at home. She said that Home Instead Senior Care has over 700 locations in North America and that number continues to increase.

Rising health care costs are a major factor in choosing to stay at home, according to Ms. Geiger and Ms. Cook. They explained that live-in caregivers are “probably half the cost of what it would take to be in a nursing home,” Ms. Geiger said, and home health aides who come a few hours a day are “a fraction of what it would cost to be in a facility of any kind,” Ms. Cook added.

Family members often become responsible for taking care of their aging parent or relative when they cannot find a caregiver. For adults with full-time jobs, taking on a role as a caregiver can become a huge burden. Ms. McKeveny has led programs for a few years that provide support and education to family caregivers who may be struggling in their new role.

“Sometimes they’re caught in a situation where their loved one was healthy one day and became very sick the next day—for example, someone can have a stroke,” she said. “That can change your life dramatically in a very short period of time. So no one really plans on that, but your role as caregiver changes very quickly.”

Local hospitals have also taken steps in recent years to support in-home care and family caregivers. In 2017, Stony Brook Southampton Hospital began offering home visits for patients in need of palliative care. And last November, Peconic Bay Medical Center in Riverhead opened a Caregivers Center in its lobby to provide resources and support to family caregivers.

Ms. Raynor said she has enjoyed working part-time for Home Instead. She likes keeping herself busy during retirement and said she has a “passion” for helping senior citizens. But the often long shifts are wearing her out.

“Any more than eight hours, I’m pretty tired,” she said.